Effects of Vascular Comorbidity on Cognition in Multiple Sclerosis Are Partially Mediated by Changes in Brain Structure
ObjectiveVascular comorbidities are associated with reduced cognitive performance and with changes in brain structure in people with multiple sclerosis (MS). Understanding causal pathways is necessary to support the design of interventions to mitigate the impacts of comorbidities, and to monitor the...
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.910014/full |
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| author | Ruth Ann Marrie Ruth Ann Marrie Ronak Patel Chase R. Figley Chase R. Figley Chase R. Figley Jennifer Kornelsen Jennifer Kornelsen Jennifer Kornelsen James M. Bolton Lesley A. Graff Erin L. Mazerolle Carl Helmick Md Nasir Uddin Md Nasir Uddin Teresa D. Figley James J. Marriott Charles N. Bernstein John D. Fisk |
| author_facet | Ruth Ann Marrie Ruth Ann Marrie Ronak Patel Chase R. Figley Chase R. Figley Chase R. Figley Jennifer Kornelsen Jennifer Kornelsen Jennifer Kornelsen James M. Bolton Lesley A. Graff Erin L. Mazerolle Carl Helmick Md Nasir Uddin Md Nasir Uddin Teresa D. Figley James J. Marriott Charles N. Bernstein John D. Fisk |
| author_sort | Ruth Ann Marrie |
| collection | DOAJ |
| description | ObjectiveVascular comorbidities are associated with reduced cognitive performance and with changes in brain structure in people with multiple sclerosis (MS). Understanding causal pathways is necessary to support the design of interventions to mitigate the impacts of comorbidities, and to monitor their effectiveness. We assessed the inter-relationships among vascular comorbidity, cognition and brain structure in people with MS.MethodsAdults with neurologist-confirmed MS reported comorbidities, and underwent assessment of their blood pressure, HbA1c, and cognitive functioning (i.e., Symbol Digit Modalities Test, California Verbal Learning Test, Brief Visuospatial Memory Test-Revised, and verbal fluency). Test scores were converted to age-, sex-, and education-adjusted z-scores. Whole brain magnetic resonance imaging (MRI) was completed, from which measures of thalamic and hippocampal volumes, and mean diffusivity of gray matter and normal-appearing white matter were converted to age and sex-adjusted z-scores. Canonical correlation analysis was used to identify linear combinations of cognitive measures (cognitive variate) and MRI measures (MRI variate) that accounted for the most correlation between the cognitive and MRI measures. Regression analyses were used to test whether MRI measures mediated the relationships between the number of vascular comorbidities and cognition measures.ResultsOf 105 participants, most were women (84.8%) with a mean (SD) age of 51.8 (12.8) years and age of symptom onset of 29.4 (10.5) years. Vascular comorbidity was common, with 35.2% of participants reporting one, 15.2% reporting two, and 8.6% reporting three or more. Canonical correlation analysis of the cognitive and MRI variables identified one pair of variates (Pillai's trace = 0.45, p = 0.0035). The biggest contributors to the cognitive variate were the SDMT and CVLT-II, and to the MRI variate were gray matter MD and thalamic volume. The correlation between cognitive and MRI variates was 0.50; these variates were used in regression analyses. On regression analysis, vascular comorbidity was associated with the MRI variate, and with the cognitive variate. After adjusting for the MRI variate, vascular comorbidity was not associated with the cognitive variate.ConclusionVascular comorbidity is associated with lower cognitive function in people with MS and this association is partially mediated via changes in brain macrostructure and microstructure. |
| first_indexed | 2024-04-12T15:08:46Z |
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| language | English |
| last_indexed | 2024-04-12T15:08:46Z |
| publishDate | 2022-05-01 |
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| series | Frontiers in Neurology |
| spelling | doaj.art-8fe24eb4b3c84631bc87d1e3328a20852022-12-22T03:27:50ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-05-011310.3389/fneur.2022.910014910014Effects of Vascular Comorbidity on Cognition in Multiple Sclerosis Are Partially Mediated by Changes in Brain StructureRuth Ann Marrie0Ruth Ann Marrie1Ronak Patel2Chase R. Figley3Chase R. Figley4Chase R. Figley5Jennifer Kornelsen6Jennifer Kornelsen7Jennifer Kornelsen8James M. Bolton9Lesley A. Graff10Erin L. Mazerolle11Carl Helmick12Md Nasir Uddin13Md Nasir Uddin14Teresa D. Figley15James J. Marriott16Charles N. Bernstein17John D. Fisk18Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, CanadaDepartment of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, CanadaDepartment of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, CanadaDepartment of Radiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, CanadaDivision of Diagnostic Imaging, Winnipeg Health Sciences Centre, Winnipeg, MB, CanadaNeuroscience Research Program, Kleysen Institute for Advanced Medicine, Winnipeg Health Sciences Centre, Winnipeg, MB, CanadaDepartment of Radiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, CanadaDivision of Diagnostic Imaging, Winnipeg Health Sciences Centre, Winnipeg, MB, CanadaNeuroscience Research Program, Kleysen Institute for Advanced Medicine, Winnipeg Health Sciences Centre, Winnipeg, MB, CanadaDepartment of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, CanadaDepartment of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, CanadaDepartment of Psychology, St. Francis Xavier University, Antigonish, NS, CanadaDepartment of Psychiatry and Division of Geriatric Medicine, Dalhousie University, Halifax, NS, CanadaDepartment of Radiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada0Department of Neurology, University of Rochester, Rochester, New York, NY, United StatesDepartment of Radiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, CanadaDepartment of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, CanadaDepartment of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada1Nova Scotia Health and the Departments of Psychiatry, Psychology & Neuroscience, and Medicine, Dalhousie University, Halifax, NS, CanadaObjectiveVascular comorbidities are associated with reduced cognitive performance and with changes in brain structure in people with multiple sclerosis (MS). Understanding causal pathways is necessary to support the design of interventions to mitigate the impacts of comorbidities, and to monitor their effectiveness. We assessed the inter-relationships among vascular comorbidity, cognition and brain structure in people with MS.MethodsAdults with neurologist-confirmed MS reported comorbidities, and underwent assessment of their blood pressure, HbA1c, and cognitive functioning (i.e., Symbol Digit Modalities Test, California Verbal Learning Test, Brief Visuospatial Memory Test-Revised, and verbal fluency). Test scores were converted to age-, sex-, and education-adjusted z-scores. Whole brain magnetic resonance imaging (MRI) was completed, from which measures of thalamic and hippocampal volumes, and mean diffusivity of gray matter and normal-appearing white matter were converted to age and sex-adjusted z-scores. Canonical correlation analysis was used to identify linear combinations of cognitive measures (cognitive variate) and MRI measures (MRI variate) that accounted for the most correlation between the cognitive and MRI measures. Regression analyses were used to test whether MRI measures mediated the relationships between the number of vascular comorbidities and cognition measures.ResultsOf 105 participants, most were women (84.8%) with a mean (SD) age of 51.8 (12.8) years and age of symptom onset of 29.4 (10.5) years. Vascular comorbidity was common, with 35.2% of participants reporting one, 15.2% reporting two, and 8.6% reporting three or more. Canonical correlation analysis of the cognitive and MRI variables identified one pair of variates (Pillai's trace = 0.45, p = 0.0035). The biggest contributors to the cognitive variate were the SDMT and CVLT-II, and to the MRI variate were gray matter MD and thalamic volume. The correlation between cognitive and MRI variates was 0.50; these variates were used in regression analyses. On regression analysis, vascular comorbidity was associated with the MRI variate, and with the cognitive variate. After adjusting for the MRI variate, vascular comorbidity was not associated with the cognitive variate.ConclusionVascular comorbidity is associated with lower cognitive function in people with MS and this association is partially mediated via changes in brain macrostructure and microstructure.https://www.frontiersin.org/articles/10.3389/fneur.2022.910014/fullmultiple sclerosisMRIcognitiondiabeteshypertension |
| spellingShingle | Ruth Ann Marrie Ruth Ann Marrie Ronak Patel Chase R. Figley Chase R. Figley Chase R. Figley Jennifer Kornelsen Jennifer Kornelsen Jennifer Kornelsen James M. Bolton Lesley A. Graff Erin L. Mazerolle Carl Helmick Md Nasir Uddin Md Nasir Uddin Teresa D. Figley James J. Marriott Charles N. Bernstein John D. Fisk Effects of Vascular Comorbidity on Cognition in Multiple Sclerosis Are Partially Mediated by Changes in Brain Structure Frontiers in Neurology multiple sclerosis MRI cognition diabetes hypertension |
| title | Effects of Vascular Comorbidity on Cognition in Multiple Sclerosis Are Partially Mediated by Changes in Brain Structure |
| title_full | Effects of Vascular Comorbidity on Cognition in Multiple Sclerosis Are Partially Mediated by Changes in Brain Structure |
| title_fullStr | Effects of Vascular Comorbidity on Cognition in Multiple Sclerosis Are Partially Mediated by Changes in Brain Structure |
| title_full_unstemmed | Effects of Vascular Comorbidity on Cognition in Multiple Sclerosis Are Partially Mediated by Changes in Brain Structure |
| title_short | Effects of Vascular Comorbidity on Cognition in Multiple Sclerosis Are Partially Mediated by Changes in Brain Structure |
| title_sort | effects of vascular comorbidity on cognition in multiple sclerosis are partially mediated by changes in brain structure |
| topic | multiple sclerosis MRI cognition diabetes hypertension |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.910014/full |
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